RÉSUMÉ
Introduction: Traffic accidents (TA) cause 1.23 million deaths each year worldwide while between 20 and 50 million persons are injured each year. In 2011 in Medellin, Colombia, there were 307 traffic deaths and 23,835 injured with 411 accidents for each 10,000 vehicles. Objective: The purpose of the study was to describe the epidemiologic and clinical characteristics, as well as the quality of life and disability outcomes for those injured in traffic accidents in Medellin. Methods: This prospective, descriptive, cross-sectional study collected data from 834 patients that were classified with the New Injury Severity Score (NISS) , the WHO-DAS-II (Disability Assessment) Scale and the SF-36 Health Survey. Results: Three-fourths (75.8%) of the patients were male. Eighty-one percent (81.0%) of patients were involved in motorcycle accidents, with 45.6% suffering moderate trauma, and 32.6% experiencing severe trauma. Of the patients with severe trauma, 8.5% were not wearing helmets. Half of the sample (49.7%) injured their extremities. The WHODAS-II domains most affected were: Activities outside the home (62.0%), Housework (54.3%) and Moving in one's environment (45.2%). Quality of life areas affected were: Physical role (20.3%), Body pain (37.3%), Emotional role (44.1%), Physical functioning (52.6%). Conclusions: Patients with more severe injuries had higher levels of disability and a worse quality of life. Motorcycles made up a large proportion of traffic accidents in this city and mitigation strategies to reduce this public health problem should particularly focus on this high-risk group.
Antecedentes: Los accidentes de tránsito (AT) causan 1.23 millones de muertes en el mundo, y entre 20 y 50 millones sufren lesiones no fatales. En Medellín (Colombia) en el 2011 hubo 307 muertos en AT y 23.835 heridos, con 411 accidentes por cada 10.000 vehículos. Objetivo: Describir las características epidemiológicas, clínicas, de calidad de vida y discapacidad de los pacientes luego de un AT en Medellín. Métodos: Estudio descriptivo trasversal prospectivo del estado inicial de una cohorte de 834 pacientes, clasificados de acuerdo a la gravedad de trauma (NISS) y las escalas WHO-DAS II y SF-36. Resultados: En el 81% de los AT estuvieron involucradas motos, con lesiones moderadas en el 45.6 %, y graves en el 32.6% de ellos. No utilizaban casco el 8.5% de los pacientes con NISS grave. En el 49.7% se afectaron los miembros inferiores. Los dominios del WHO-DAS II más afectados fueron: actividades fuera del hogar (62.0%) actividades domésticas (54.3%) y moverse en el entorno (45.2%). La calidad de vida comprometió los dominios de desempeño físico (20.3%), dolor corporal (37.3%), desempeño emocional (44.1%) y funcionamiento físico (52.6%). Conclusiones: Los pacientes con lesiones más graves tuvieron mayor compromiso en la discapacidad y en la calidad de vida. Esta carga de enfermedad la producen principalmente los AT en los que están involucradas las motos.
RÉSUMÉ
OBJECTIVES: This study aimed to identify the predictors for change in disability measured by the Korean version of World Health Organization Disability Assessment Schedule II (WHODAS II-K) in community-dwelling elderly population. METHODS: Of 1204 community participants aged 65 years or over, 717 were reevaluated by WHODAS II-K 2 years later. At baseline, information on demographic characteristics (age, gender, living area, marital status, and religion), socioeconomic status (education, type of accommodation, number of rooms, previous occupation, current employment, and social network), and clinical characteristics (number of physical illness, depression by the Korean version of Geriatric Mental State Schedule B3, and cognitive impairment by Korean version of Mini-Mental State Examination) were collected. RESULTS: Scores on the WHODAS II-K increased by 17.5 in 2 years. Age (B coefficient 0.52, 95% CI: 0.21~0.84), number of rooms (B coefficient -1.92, 95% CI: -3.53~-0.30), and depression (B coefficient 1.84, 95% CI: 0.43~3.25) were independently significant predictors for change in disability. CONCLUSION: Change in the level of disability measured by the WHODAS II-K was mainly affected by age, number of rooms, and depression. These results can be useful for the development of community-based health promotion program for the elderly.
Sujet(s)
Sujet âgé , Humains , Rendez-vous et plannings , Dépression , Emploi , Promotion de la santé , Situation de famille , Professions , Classe sociale , Organisation mondiale de la santéRÉSUMÉ
OBJECTIVES: This study aimed to develop the Korean version of World Health Organization Disability Assessment Schedule II (WHODAS II-K) with community dwelling elderly population. METHODS: The WHODAS II-K was administered to 1204 community residents aged 65 or over in two areas of Kwangju, South Korea, in 2001. For assessing 'health condition', data on physical illness, depression (Korean version of Geriatric Mental State Schedule B3), and cognitive dysfunction (Korean version of Mini-Mental State Examination) were collected. For evaluating 'contextual factors', informations on demographic characteristics (age, gender, living area, marital state, and religiou), socioeconomic status (education, type of accommodation, number of room, previous occupation, and current employment), and social network were obtained. RESULTS: WHODAS II-K showed high levels of internal consistency, split-half reliability, and inter-rater and test-retest reliabilities. In the correlation analyses, scores on the WHODAS II-K were significantly correlated with the unfavorable conditions in the all variables on health condition and contextual factors. Partial correlations of scores on the WHODAS II-K with health condition were significant even after controlling for contextual factors. CONCLUSION: The WHODAS II-K is a reliable and valid instrument for assessing disability in elderly population since it reflects physical illness, depression, and cognitive impairment, which are common in elderly.